TISSUE ENZYME ACTIVITIES IN KEMP'S RIDLEY TURTLES (LEPIDOCHELYS KEMPII)

BLOOD AND TISSUE ENZYME ACTIVITIES IN BEARDED DRAGONS (POGONA VITTICEPS)

Bearded dragons (Pogona vitticeps) are a common reptile species kept under human care and suffer from a wide range of diseases for which plasma biochemistry is used as a first-line diagnostic test. There is limited information available regarding tissue enzyme activities and origin that could assist in interpreting the bearded dragon plasma biochemistry enzymology profile. The aim of this study was to characterize the tissue activities of seven enzymes routinely used in the reptile biochemistry panel: alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), and creatine kinase (CK) in 12 adult inland bearded dragons in 13 tissues, plasma, and red blood cells. CK activity was highest in skeletal muscle followed by cardiac muscle; ALT and AST were distributed in several tissues and were relatively non-specific for all organs, additionally hepatic fat accumulation reduced AST hepatic activity on a weight per weight basis. ALP and GGT activities were mostly high in the kidneys; LDH activity was elevated in cardiac muscle and skeletal muscle followed by liver; and GLDH had primarily high enzyme activities in liver. Low red blood cell enzyme activities suggest that hemolysis is unlikely to artifactually increase AST or LDH plasma concentrations. These results provide a stepping stone to improve the interpretation of biochemistry results in bearded dragons, especially as it compares to other reptile species.

CLINICAL AND PATHOLOGIC FINDINGS IN IGUANIDS WITH SODIUM URATE CHOLELITHIASIS

Four green iguanas (Iguana iguana) and one blue iguana (Cyclura lewisi) from five facilities were diagnosed with sodium urate cholelithiasis. One case was diagnosed antemortem via ultrasonography, and the iguana underwent a choledochotomy for treatment. The other four cases were identified at necropsy. Pathologic hepatic and biliary changes were present in four of the five cases at necropsy. Histologically, four iguanas had hepatic fibrosis, three had bile duct hyperplasia, and one had cholangiohepatitis and pancreaticocholedochitis. Two iguanas had pathologic renal changes. This is the first report of sodium urate cholelithiasis in reptiles. This case series highlights the potential significant clinical disease caused by sodium urate cholelithiasis and the importance of biliary system evaluation. Further investigation is recommended to explore the pathogenesis of reptilian sodium urate cholelith formation.

On the significance of aspartate aminotransferase and creatine kinase in wild reptile health studies

In reptile medicine, the enzymes aspartate aminotransferase (AST) and creatine kinase (CK) have been used in clinical diagnostics, where CK is considered an enzyme specific to muscle cell damage, while AST is a nonspecific enzyme that is mainly produced in the liver and muscle. When many native reptiles are sampled, it is evident that there are important differences between species and individuals belonging to the same species, making the AST and CK ranges very wide. The minimum and maximum values, variations and standard deviations were extracted for each enzyme from 17 wild reptile studies, revealing high variation and a wide range of variation for each species. AST and CK must be interpreted with caution in wild reptiles since there appears to be an important amount of individual and specific variation due to the muscular origin of these enzymes, and such variations tell us that there are considerable differences between individuals, physiological characteristics or sampling methods; thus, there is no apparent value derived from these kinds of studies on the utility of AST for evaluating liver damage, but the measurement of AST and CK can be useful for reptile health assessments or any manipulative study since they can eventually be used as indicators or potential biomarkers for restraint techniques or holding time.

Blood analyte reference intervals and correlations with trace elements of immature and adult Eastern Pacific green turtles (Chelonia mydas) in coastal lagoons of Baja California Sur, México

Sea turtles can bioaccumulate high concentrations of potentially toxic contaminants. To better understand trace element effects on sea turtles' health, we established reference intervals for hematological and plasma biochemical analytes in 40 in-water, foraging immature and adult Eastern Pacific green turtles (Chelonia mydas) from two coastal lagoons in Baja California Sur, quantified whole blood concentrations of eight trace elements, and assessed their correlations. Rank-order trace element concentrations in both immature and adult turtles was zinc > selenium > nickel > arsenic > copper > cadmium > lead > manganese. Immature turtles had significantly higher copper and lower nickel and zinc concentrations. Additionally, a number of relationships between trace elements and blood analytes were identified. These data provide baseline information useful for future investigations into this population, or in other geographic regions and various life-stage classes.

Clinical Pathology of Freshwater Turtles

Freshwater turtles are physiologically unique in their adaptations to life on both land and freshwater habitats. Appropriate interpretation of laboratory values specific to these species is important for both conservation efforts in free-ranging populations and in captive populations, especially because these animals become increasingly popular as pets. Although normal physiology has been well characterized, understanding of clinicopathologic changes in response to disease processes in freshwater chelonian species is relatively limited. This article reviews the current knowledge of hematology, plasma biochemistry, and urinalysis specific to freshwater turtles, with correlates to other chelonian species when specific data are unavailable.

Plasma and tissue enzyme activities of banded water snakes (Nerodia fasciata) and diamondback water snakes (Nerodia rhombifer)

OBJECTIVE

To measure plasma and tissue activities of alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase (AST), creatine kinase, and γ-glutamyltransferase in 2 snake species.

ANIMALS

6 banded water snakes (Nerodia fasciata) and 6 diamondback water snakes (Nerodia rhombifer).

PROCEDURES

Blood was collected via the ventral tail vein to measure plasma enzyme activities. Animals were then euthanized, and samples of 9 tissues were collected from each snake: skeletal muscle, cardiac muscle, liver, spleen, lung, kidney, testicle, pancreas, and gallbladder. Tissues were frozen for 30 days, then homogenized and processed. Supernatants were collected and analyzed within 24 hours of processing. A linear mixed model was used to determine differences in enzyme activity between tissues and species and assess interactions between tissues and species.

RESULTS

Activities of all enzymes were found to differ significantly among tissues. There were also significant differences between species for all enzyme activities, except AST activity. The kidney had the highest alanine aminotransferase and γ-glutamyltransferase activities. Alkaline phosphatase activity was significantly highest in liver and kidney tissues than in other tissue. Creatine kinase activity was highest in skeletal muscle, followed by cardiac muscle and kidney. AST activity was present in all tissues evaluated, but was highest in liver, kidney, and cardiac muscle in both species.

CLINICAL RELEVANCE

Results reinforced the importance of characterizing the origin of tissue enzymes in reptiles to improve our understanding of biochemistry results and highlighted the differences that can exist in tissue enzyme activities between closely related species.

Health status of Polychrus gutturosus based on physical examination, hematology and biochemistry parameters in Costa Rica

Studies evaluating the health status and characteristics of free-ranging wildlife populations are scarce or absent for most species. Saurian health assessments are usually performed in species that have conservation issues or that are kept in captivity. The Berthold’s bush anole (Polychrus guturossus) is one of eight species belonging to the genus Polychrus, the only representative of the family Polychrotidae. Only a handful of studies have been reported concerning these lizard’s morphological variation, ecology, and natural history, probably because P. gutturosus is a canopy dweller and it can be difficult to locate individuals. It is believed that deforestation and habitat modification could pose a threat for this species, although to date no health assessment has been done. The aim of this study was to generate health baseline data on P. gutturosus. Forty Berthold’s bush anoles (20 males and 20 females) were sampled at the Pacific versant in Costa Rica, where physical examination, skin and cloacal temperatures, and blood samples were obtained from individuals immediately after capture. Animals from the studied population were all healthy (body condition 2.5–3.0/5.0). No lesions or ectoparasites were detected, but hemoparasites were found in nine individuals. Hematological and biochemical values were obtained, and the morphology of leukocytes were found to be similar to other iguanians. A positive correlation was found between the tissue enzymes aspartate aminotransferase (AST) and creatinine kinase (CK) and a negative correlation was found between skin and cloacal temperatures and AST and CK. There were positive correlations between female weight and total protein, calcium, and the calcium and phosphorus ratio. No significant inter-sex differences were found in biochemical values, despite females being larger than males. This is the first health assessment performed on a free-ranging canopy dwelling lizard. These findings provide baseline data that may be useful for future monitoring if the species faces changes in health status due to anthropogenic causes or natural disturbances.

The use of echocardiography as a health assessment tool in green sea turtles (Chelonia mydas)

There are limited techniques available to assess the health of sea turtles as physical examination has little correlation to clinical findings, and blood reference intervals are broad and provide limited prognostic significance. Advances in the portability of ultrasound machines allow echocardiography to be increasingly used in the health assessments of wild animals. This study performed blood analysis and echocardiograms on 11 green sea turtles upon admission to a rehabilitation clinic and six animals before release. Significant differences were seen between groups, with admission animals having significantly smaller diameters of the cavum arteriosum at systole and diastole, smaller E-waves and an increased fractional shortening. Pre-release animals displayed significant increases in the maximum blood velocities of both the pulmonary artery and the left aorta. Significant negative correlations were seen between fractional shortening and uric acid and between the velocity time integral of the pulmonary artery and urea. The pulmonary artery velocity time integral was also significantly correlated to the E wave. Furthermore, there was asynchrony between the cavum arteriosum and the cavum pulmonale and the detection of a parasitic granuloma in the ventricular outflow tract of one animal. Overall, the results suggest that cardiac function in stranded green sea turtles is significantly impaired and that echocardiography has applications in the health assessments of green sea turtles.

Blood analytes of immature Kemp's ridley sea turtles (Lepidochelys kempii) from Georgia, USA: reference intervals and body size correlations

Health assessments of wildlife species are becoming increasingly important in an ever-changing environment. Kemp's ridley sea turtles (Lepidochelys kempii; hereafter, Kemp's ridleys) are critically endangered and incur several on-going threats to their population recovery; therefore, it is imperative to advance the understanding of baseline blood analyte data as a diagnostic and monitoring tool. For in-water, trawl-captured, immature Kemp's ridleys (minimum N = 31) from Georgia, USA, the objectives of this study were to (1) establish reference intervals (RIs) for packed cell volume (PCV) and 27 plasma biochemistry analytes and (2) determine length-specific relationships in blood analytes. We observed significant positive correlations between minimum straight carapace length and PCV, amylase, calcium:phosphorus ratio, cholesterol, magnesium, triglycerides, total solids, total protein and all protein fractions (e.g. alpha-, beta- and gamma-globulins); aspartate aminotransferase and chloride showed significant negative relationships. These results suggest that certain blood analytes in Kemp's ridleys change as these animals grow, presumptively due to somatic growth and dietary shifts. The information presented herein, in due consideration of capture technique that may have impacted glucose and potassium concentrations, represents the first report of blood analyte RIs for Kemp's ridley sea turtles established by guidelines of the American Society for Veterinary Clinical Pathology and will have direct applications for stranded individuals in rehabilitative care and for future investigations into the health status of wild individuals from this population.

Hepatic CT attenuation differs in three species of freshwater turtles and hepatic Hounsfield units increase with folliculogenesis in wild Blanding's turtles (Emydoidea blandingii)

Freshwater turtle species are suffering from anthropocentric-caused population declines, making preservation of professionally managed populations increasingly important. Turtles under professional care have an increased risk to develop hepatic lipidosis, potentially resulting in early death. Computed tomography can provide an antemortem screening for increased fatty liver composition. A goal of this prospective analytical cross-sectional study was to assess the hepatic attenuation measured as Hounsfield units (HU) in a wild population of a freshwater turtle species, and then compare hepatic HU to freshwater turtles under professional care. Ninety-five wild Blanding's turtles (BT; Emydoidea blandingii) as well as 10 Vietnamese Pond turtles (VPT; Mauremys annamensis) and six Northern Snake-Necked turtles (NSNT; Chelodina oblonga) under professional care underwent CT with quantification of hepatic HU. Hepatic HU were correlated to serum chemistry findings and the presence of follicles was recorded in BT. The mean (±SD) hepatic attenuation for 95 wild BT was 97.5 HU ±9.6. There were significant differences in hepatic attenuation among VPT, NSNT, and BT, with median HU values (range) of 5.39 HU (-6.45 to 61.50), 71.74 HU (59.44-94.49), and 95.43 HU (74.41-124.56), respectively. Aspartate aminotransferase (AST) values had a weak negative correlation to HU with a coefficient of -0.85 (P < .001). The hepatic attenuation was significantly higher for individuals undergoing folliculogenesis (P = .007). The decreased HU values were significantly negatively correlated with AST values. Findings supported the use of CT as an aid for guiding future management practices in freshwater turtles.

Evaluation of point-of-care analysers for blood gas and clinical chemistry in Hermann's tortoises (Testudo hermanni)

OBJECTIVE

To assess the agreement between point-of-care and laboratory analysers in measuring biochemical and blood gas analytes in venous samples from tortoises and to define preliminary reference intervals for venous blood gas analysis in Hermann's tortoises (Testudo hermanni).

MATERIALS AND METHODS

Jugular venous blood samples from 47 Hermann's tortoises underwent paired analysis with a portable gas analyser (i-STAT 1, Abaxis), a portable chemical analyser (VetScan VS2, Abaxis), and with the respective reference analysers. Agarose gel electrophoresis was used to determine albumin concentrations on 12 specimens. Agreement was evaluated with Bland-Altman plots and regression analysis using the Passing-Bablok method.

RESULTS

Point-of-care analysers had variable agreement with the reference analysers, presenting constant or proportional bias depending on the analyte. Relevant analytes in reptiles, such as ionised and total calcium, had acceptable agreement. The method for determining albumin concentration currently available in both point-of-care and laboratory analysers significantly overestimated albumin concentrations as compared to protein electrophoresis.

CLINICAL SIGNIFICANCE

While the use of POC analysers is extremely advantageous in small animal primary care facilities, agreement between point-of-care and laboratory analysers varies depending on the analyte. For certain analytes, interchangeability of results is limited and specific reference intervals for point-of-care analysers are required. Veterinarians should be aware of the size and the direction of the bias of each analyte.

Evidence-Based Advances in Reptile Medicine

Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty.